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Vitamin Supplement Use in a Low-Risk Population of US Male Physicians and Subsequent Cardiovascular Mortality
Jorg Muntwyler, MD, MPH;
Charles H. Hennekens, MD, DrPH;
JoAnn E. Manson, MD, DrPH;
Julie E. Buring, ScD;
J. Michael Gaziano, MD, MPH
Arch Intern Med. 2002;162:1472-1476.
Background Although basic research suggests that vitamins may have an important role in the prevention of cardiovascular diseases (CVD), the data from cohort studies and clinical trials are inconclusive.
Methods This prospective cohort study was conducted among 83 639 male physicians residing in the United States who had no history of CVD or cancer. At baseline, data on use of vitamin E, ascorbic acid (vitamin C), and multivitamin supplements were provided by a self-administered questionnaire. Mortality from CVD and coronary heart disease (CHD) was assessed by death certificate review.
Results Use of supplements was reported by 29% of the participants. During a mean follow-up of 5.5 years, 1037 CVD deaths occurred, including 608 CHD deaths. After adjustment for several cardiovascular risk factors, supplement use was not significantly associated with total CVD or CHD mortality. For vitamin E use, the relative risks (RRs) were 0.92 (95% confidence interval [CI], 0.70-1.21) for total CVD mortality and 0.88 (95% CI, 0.61-1.27) for CHD mortality; for use of vitamin C, the RRs were 0.88 (95% CI, 0.70-1.12) for total CVD mortality and 0.86 (95% CI, 0.63-1.18) for CHD mortality; and for use of multivitamin supplements, the RRs were 1.07 (95% CI, 0.91-1.25) for total CVD mortality and 1.02 (95% CI, 0.83-1.25) for CHD mortality.
Conclusions In this large cohort of apparently healthy US male physicians, self-selected supplementation with vitamin E, vitamin C, or multivitamins was not associated with a significant decrease in total CVD or CHD mortality. Data from ongoing large randomized trials will be necessary to definitely establish small potential benefits of vitamin supplements on subsequent cardiovascular risk.
From the Department of Internal Medicine, University Hospital of Zurich, Zurich, Switzerland (Dr Muntwyler); University of Miami School of Medicine, Miami, Fla (Dr Hennekens); and Division of Preventive Medicine (Drs Manson, Buring, and Gaziano) and Cardiovascular Division (Dr Gaziano), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Department of Ambulatory Care and Prevention, Harvard Medical School (Dr Buring); Department of Epidemiology, Harvard School of Public Health (Drs Manson and Buring); and the Massachusetts Veterans Epidemiology Research and Information Center, Boston Veterans Affairs Healthcare System (Dr Gaziano), Boston, Mass.
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